Complications after 1000 lung radiofrequency ablation sessions in 420 patients: a single center's experiences.

Abstract

OBJECTIVE:

This study retrospectively evaluates complications after lung radiofrequency ablation (RFA).

MATERIALS AND METHODS:

Complications were assessed for each RFA session in 420 consecutive patients with 1403 lung tumors who underwent 1000 RFA sessions with a cool-tip RFA system. A major complication was defined as a grade 3 or 4 adverse event. Risk factors affecting frequent major complications that occurred with an incidence of 1% or more were detected using multivariate analysis.

RESULTS:

Four deaths (0.4% [4/1000]) related to RFA procedures occurred. Three patients died of interstitial pneumonia. The other patient died of hemothorax. The major complication rate was 9.8% (98/1000). Frequent major complications were aseptic pleuritis (2.3% [23/1000]), pneumonia (1.8% [18/1000]), lung abscess (1.6% [16/1000]), bleeding requiring blood transfusion (1.6% [16/1000]), pneumothorax requiring pleural sclerosis (1.6% [16/1000]), followed by bronchopleural fistula (0.4% [4/1000]), brachial nerve injury (0.3% [3/1000]), tumor seeding (0.1% [1/1000]), and diaphragm injury (0.1% [1/1000]). Puncture number (p < 0.02) and previous systemic chemotherapy (p < 0.05) were significant risk factors for aseptic pleuritis. Previous external beam radiotherapy (p < 0.001) and age (p < 0.02) were significant risk factors for pneumonia, as were emphysema (p < 0.02) for lung abscess, and serum platelet count (p < 0.002) and tumor size (p < 0.02) for bleeding. Emphysema (p < 0.02) was a significant risk factor for pneumothorax requiring pleural sclerosis.

CONCLUSION:

Lung RFA is a relatively safe procedure, but it can be fatal. Risk factors found in this study will help to stratify high-risk patients.

• Authors: Masataka Kashima, Koichiro Yamakado, Haruyuki Takaki, Hiroshi Kodama, Tomomi Yamada, Junji Uraki, Atsuhiro Nakatsuka
• Journal: AJR. American journal of roentgenology (AJR Am J Roentgenol) Vol. 197 Issue 4 Pg. W576-80 (Oct 2011) ISSN: 1546-3141 [Electronic] United States
• PMID: 21940529 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Catheter Ablation (methods)
• Child
• Child, Preschool
• Diagnostic Imaging
• Female
• Humans
• Incidence
• Logistic Models
• Lung Neoplasms (diagnosis, mortality, surgery)
• Male
• Middle Aged
• Postoperative Complications (diagnosis, epidemiology, mortality)
• Retrospective Studies
• Risk Assessment
• Risk Factors